Our surgical strategies in repair of coarctation of aorta in adult patients and long-term follow-up

Özet

Objectives: This study aims to examine the effect of surgical strategies in repair of coarctation of aorta on systolic hypertension and long-term results. Patients and methods: A total of 13 adult patients (9 males, 4 females; mean age: 31.4±11.8 years; range, 18 to 51 years) who underwent aortic coarctation surgical repair between March 1990 and November 2016 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients were recorded. Repair of coarctation of aorta was carried out with a left posterolateral thoracotomy through fourth intercostal space in 10 patients. Extra-anatomic aortic bypass grafting through median sternotomy was performed in three patients. Results: The mean follow-up was 131.4±112.6 (range, 2 to 312) months. No mortality was observed in any of the patients. The systolic blood pressures of the patients receiving and not receiving medical treatment preoperatively significantly decreased postoperatively and during follow-up (p≤0.05). Pleural effusion was seen in one patient with recurrent coarctation postoperatively. Postoperative atrial fibrillation persisted, despite medical treatment, in four patients who had atrial fibrillation preoperatively. Twelve (92.3%) patients had New York Heart Association (NYHA) Class I and one (7.7%) patient had Class II symptoms during follow-up (p<0.05). At the final follow-up visit, only three patients were normotensive without receiving any anti-hypertensive medication. Conclusion: Different surgical methods can be performed conformably to aortic coarctation and associated cardiac disease. Surgical repair of aortic coarctation in adults has a low risk and is an effective method in decreasing the systolic hypertension, reducing the requirement of antihypertensive medications and clinical symptoms.